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Exploring the use of smartphones and tablets among people with visual
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Exploring the use of smartphones and tablets

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Natalina Martiniello, Werner Eisenbarth, Christine Lehane, Aaron Johnson &

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ASSISTIVE TECHNOLOGY
https://doi.org/10.1080/10400435.2019.1682084

Exploring the use of smartphones and tablets among people with visual
impairments: Are mainstream devices replacing the use of traditional visual aids?
Natalina Martiniello, MSc, CVRT a,b, Werner Eisenbarth, PhDc, Christine Lehane, PhD d
, Aaron Johnson, PhDe,
and Walter Wittich, PhD, FAAO, CLVT a,b
a
School of Optometry, University of Montreal, Montreal, Quebec, Canada; bResearch Services, CRIR/Centre de réadaptation MAB-Mackay du CIUSSS du
Centre-Ouest-de-l’Île-de-Montréal, Montreal, Quebec, Canada; cZentrums für angewandte Sehforschung, Munich University of Applied Sciences, Munich,
Germany; dDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark; eDepartment of Psychology, Concordia University, Montreal,
Quebec, Canada

ABSTRACT ARTICLE HISTORY

Smartphones and tablets incorporate built-in accessibility features, but little is known about their impact Accepted 11 October 2019
within the visually impaired population. This study explored the use of smartphones and tablets, the
KEYWORDS
degree to which they replace traditional visual aids, and factors influencing these decisions. Data were computer access;
collected through an anonymous online survey targeted toward visually impaired participants above the information technology and
age of 18, whom had been using a smartphone or tablet for at least three months. Among participants telecommunications;
(n = 466), 87.4% felt that mainstream devices are replacing traditional solutions. This is especially true for universal design; usability;
object identification, navigation, requesting sighted help, listening to audiobooks, reading eBooks and visual impairment
optical character recognition. In these cases, at least two-thirds of respondents indicated that mainstream
devices were replacing traditional tools most or all of the time. Users across all ages with higher self-
reported proficiency were more likely to select a mainstream device over a traditional solution. Our results
suggest that mainstream devices are frequently used amongst visually impaired adults in place of or in
combination with traditional assistive aids for specific tasks; however, traditional devices are still preferable
for certain tasks, including those requiring extensive typing or editing. This provides important context to
designers and rehabilitation personnel in understanding the factors influencing device usage.

Introduction (Crossland, Silva, & Macedo, 2014; Griffith-Shirley et al., 2017;

People with visual impairments (that is, those who are blind or
who have low vision, as defined by World Health Organization,
1992) use a myriad of assistive devices (such as hand-held
magnifiers and screen-reading software) to mitigate the limita-
tions posed by their visual impairments. Historically, traditional
assistive devices refer to those specialized high and low tech tools
designed for individuals with disabilities to increase their access
to both the environment and written information, such as spe-
cialized screen-reading software, magnification programs and
daisy book readers (Presley & D’Andrea, 2008). Despite their
established utility, widespread adoption of such traditional assis-
tive devices is often impeded by factors such as cost and deeply
rooted negative perceptions associated with vision loss (Mulloy,
Gevarter, Hopkins, Sutherland, & Ramdoss, 2014). Over the past
decade, there has been a marked increase in the use of main-
stream devices (such as smartphones and tablets), which are
employed by the general population but also incorporate built-
in accessibility features for users with diverse needs. These
devices may lead to less abandonment as they are typically
more affordable, are less likely to draw attention to the user,
and are widely adopted by the general population (Irvine et al.,
2014). While prior studies have investigated the use of such
mainstream tools among people with visual impairments
Kane, Jayant, Wobbrock, & Ladner, 2009; Rodrigues, Montague,
Nicolau, & Guerreiro, 2015; Watanabe, Yamaguchi, & Minatani,
2015), we do not precisely know how such mainstream devices
are being used, the degree to which they are replacing traditional
visual aids for different tasks, or the factors which influence these
decisions. This context would provide valuable information to
designers, trainers and rehabilitation professionals in order to
better meet the increasingly heterogeneous needs within the
visually impaired population. Here we present the results from
an international study which explores these questions in greater
depth.
Review of the literature
Assistive devices are tools (such as magnifiers, telescopes and
talking book readers) that maintain or improve the functional
abilities of persons with disabilities and therefore support
their inclusion within society (Raskind, 2013). For those
with acquired vision loss, such devices facilitate the ability to
resume daily activities such as reading, cooking, and traveling.
As a consequence, they can enhance a users’ subjective quality
of life and self-esteem (Scherer & Glueckauf, 2005). Despite
these established benefits, abandonment and disuse of

CONTACT Natalina Martiniello, MSc, CVRT natalina.martiniello@umontreal.ca School of Optometry, Université de Montréal, 3744, rue Jean-Brillant, room
260-7 Montréal, (Québec) H3T 1P1, Canada.
Supplemental data for this article can be accessed on the publisher’s website.
© 2019 The Author(s). Published with license by Taylor & Francis Group, LLC.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/),
which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
2 N. MARTINIELLO ET AL.
traditional assistive devices are alarmingly high, with some
reports indicating that the percentage of abandonment ranges
from 30% to 50% for devices in aggregate, and up to 75% for
particular devices (Furer, 2001). Though reasons for the aban-
donment of traditional assistive devices are diverse, explana-
tions include cost, lack of technical support, and the stigma
attached to their use (Phillips & Proulx, 2018; Sugawara,
Ramos, Alfieri, & Battistella, 2018).
The expense of traditional assistive devices (such as screen
reading and magnification software) limits the ability for
many potential users to consider device acquisition (Gordon,
Kerzner, Sheldon, & Hansen, 2007). While assistive device
attribution and training are funded through some health-
care programs, many jurisdictions do not have established
governmental funding programs, and those in existence differ
significantly with regards to eligibility criteria and funding
levels (Gordon et al., 2007). This is especially pertinent
given that the employment rate for individuals with visual
impairments in most western countries is estimated to be less
than 40%, thus relegating many potential users of assistive
devices to lower-income brackets (Martiniello & Wittich,
2019). Access to funding issues are compounded for those
with acquired vision loss who are neither studying nor work-
ing, and therefore often do not meet eligibility criteria.
Moreover, the specialized nature of traditional assistive
devices limits the ability for device users and persons within
the user’s social network (such as family members and main-
stream technical support personnel) to assist when technical
problems arise (Jarry, Chapdelaine, Kurniawan, & Wittich,
2017). Caregivers and family members typically have limited
(if any) knowledge on the use of traditional assistive devices,
may not understand how they work, and/or do not know how
to facilitate the use of the device in daily living activities
(Gitlin, 1995).
A body of previous work has also explored the stigma
associated with traditional assistive devices for users who are
still adjusting to acquired impairments. Such specialized
devices attract attention from the general public and therefore
uncover otherwise invisible disabilities (such as low vision
that may otherwise not be apparent). Pape, Kim, and
Weiner (2002) found that people with disabilities are more
likely to abandon an assistive device if they had not yet
accepted their impairment, if the device led them to feel
excluded and different from others, and if the device was
perceived by the user to be different from the norm.
Likewise, Shinohara (2011) found that respondents expressed
sensitivity toward the reaction of others around them when
using their assistive devices, taking note when another person
appeared uncomfortable, either by furtive looks or tone of
voice. The presence of self-conscious feelings was associated
with the existence of an invisible disability (such as low
vision), which may otherwise not be apparent without explicit
disclosure. This was particularly the case when using devices
traditionally associated with impairment (such as a white
cane), and when the design attracted attention due to differ-
ences from mainstream products used by the general public
(Shinohara, 2011). Conversely, it has also been suggested that
some users with invisible impairments value traditional
assistive devices that ‘stand out’ because they alert members
of the public to an otherwise undisclosed disability or illness
when assistance may be needed (Faucett, Ringland, Cullen, &
Hayes, 2017).
The potential stigma of traditional assistive devices may be
mitigated through mainstream devices which follow principles
of universal design to address a range of user abilities and
needs (Story, 1998). Many mainstream smartphones and
tablets (such as those produced by Apple and Google) now
incorporate built-in accessibility features that enable them to
be used by individuals who are blind or who have low vision,
without the need to use specialized traditional assistive solu-
tions that set them apart from others (Watanabe et al., 2015).
Among the built-in accessibility enhancements available on
mainstream smartphones and tablets, users with low vision
can adjust color, contrast and size, and customize the level of
brightness to improve visibility and readability. Similarly,
users who are functionally blind can activate speech output
software (such as VoiceOver on Apple devices and Google
Talk-Back on Android devices) that reads information aloud
through the use of gestures and commands (Irvine et al.,
2014). Such built-in speech-output software (which tradition-
ally had to be purchased through expensive, third-party ven-
dors) provides highly sophisticated assistance and enables
users to read virtually any text on the screen (such as
e-mails, internet pages, instant messages, and eBooks).
Moreover, voice-controlled, digital assistants (such as SIRI
and Alexa) can be used to both readout text and perform
a variety of tasks (e.g., open apps, perform online searches,
send messages and start a phone call). To facilitate the com-
pletion of writing tasks, such software incorporates a dictation
feature which converts spoken words into text, a functionality
that is particularly useful for those with motor impairments or
who otherwise cannot access the on-screen keyboard.
Prior research has investigated blind and visually impaired
users’ utilization of smartphones and tablets, and the specific
accessibility functionalities employed. Kane et al. (2009), rela-
tively early in the smartphone adoption era, conducted
a qualitative study to explore the use of smartphones as
assistive devices among users who were visually impaired or
who had motor impairments, and explored many of the
practical challenges associated with the use of mobile devices
as accessibility aids. Rodrigues, Montague, Crossland et al.
(2014) found that Apple products remain the most commonly
used operating system among users with visual impairments
and that the use of smartphones remains relatively consistent
(mean of 79% up to age 64) until the age of 65 where usage
sharply declined in their sample (mean of 26%). The authors
report that the use of tablet computers among seniors
increases with age, suggesting a possible correlation between
age and device usage. Rodrigues et al. (2015), through inter-
views and a usage diary analysis of five participants with
visual impairments, identified several barriers to adoption of
an Android-based smartphone including a steep learning
curve and inconsistent navigation from app to app, but
found that most users quickly adopted the phone to aid in
their day-to-day tasks. Griffith-Shirley et al. (2017) conducted
a survey of 259 smartphone and tablet users to explore their

usage of free and paid apps (both generally used and those
developed specifically for the blind and low-vision popula-
tion) and found that 95.4% used smartphones, 40.5% used
tablets, 37.1% used both, and the significant majority (79.9%)
were Apple iOS users, while only 7% used Android. Little
remains known, however, about the factors which contribute
to a users’ decision to select a specific device, or in what ways
mainstream tools may be replacing traditional visual aids for
different segments of the visually impaired population.
Objective and research questions
Given the above context, the purpose of this study was to
explore the use of mainstream devices among participants
with visual impairments, and specifically, to determine
whether smartphones and tablets are used in place of tradi-
tional visual aids for certain tasks. Given the increased func-
tionality of such mainstream tools, it was hypothesized that
smartphones and tablets are replacing traditional assistive
devices, depending on the tasks to be performed, the age of
participants and their level of vision. Three research questions
guided the analyses:
(1) What mainstream touch-screen devices (smartphone
and tablets), accessibility features and installable apps
are being used by individuals who are blind or who
have low vision?
(2) Are users replacing the use of traditional assistive
devices with smartphones and tablets for certain
functional tasks?
(3) What factors (such as demographic variables or device
characteristics) influence the decision to use either
a traditional or mainstream device for specific tasks?
Results from this study will provide useful context to both
designers and rehabilitation professionals who intervene
directly with individuals who are blind or who have low
vision. In particular, such results illuminate whether specific
segments of the population – such as older adults – choose to
use traditional or mainstream devices for different functional
tasks, and whether specific factors, such as ease of use and
physical features of the device, impact these decisions. As the
population becomes increasingly diverse and heterogeneous,
such factors can inform the design of assistive devices, and
provide context for how rehabilitation professionals can best
support and train the use of such tools to meet the needs of
a diverse clientele.
Materials and methods
Data were collected through an anonymous online survey
maintained by Hosted in Canada Surveys between September
and December 2017. Ethics approval was obtained through the
Center for Interdisciplinary Research in Rehabilitation of
Greater-Montreal (CRIR #1238-0816) in order to recruit parti-
cipants through the network of Quebec-based vision rehabilita-
tion centers. Prior to beginning the survey, respondents read
about the nature of the study and their participation on the
initial page of the website. Informed consent was obtained by
ASSISTIVE TECHNOLOGY 3
the decision to proceed with the online survey, in accordance
with The Declaration of Helsinki and Public Health (Williams,
2008). Participants also had the option to provide their e-mail
address if they wished to receive a summary of results and/or
enter a draw to win a $100 iTunes or GooglePlay gift card (and
426 of the 466 participants did so). In such cases, the contact
information was kept separate from survey responses in
a confidential, encrypted, password protected file.
Eligibility and recruitment
Participation was open to those who were at least 18 years of
age, who had been using a smartphone or tablet for at least three
months, and who self-identified as having a mild, moderate,
severe or profound visual impairment that is either congenital
or acquired, in line with the visual acuity and fields defined by
the World Health Organization (WHO, 1992, as described in
Table 1). Due to the linguistic diversity of the research team, the
survey was made available in English, French, and German in
order to expand recruitment efforts internationally.
Once ethical approval was obtained, the invitation to par-
ticipate was posted to over 150 pre-identified English, French
and German social media groups geared toward members of
the blind and low-vision community. In addition, the invita-
tion was circulated to approved vision rehabilitation centers
and consumer organizations serving blind, low vision and
deafblind individuals throughout North America and the
European Union. Finally, snowball sampling (whereby parti-
cipants were invited to share the invitation with others they
know) provided additional reach beyond these initial contacts
(Goodman, 1961).
Materials and procedure
The survey consisted of approximately 55 questions, and
required on average 42.7 (SD = 32.7) minutes to complete.
The number of questions asked of any given respondent
depended on participants’ responses: for example, an individual
who used both a smartphone and a tablet had to complete both
sections of the survey, increasing the number of questions
asked. The survey was pilot tested by two individuals before-
hand to ensure accessibility for participants who use magnifica-
tion or screen-reading software. Data were collected through
a combination of close-ended and open-ended questions (the
full survey instrument can be found in the Supplemental
Materials). The first portion of the survey collected
Table 1. Definition of blindness and low vision (and its associated categories),
per WHO (1992) classifications.
Category Definition
Mild Best-corrected distance acuity (in the better eye) of worse than
20/40 but better or equal to 20/60, or a reduced visual field of less
than 60 degrees
Moderate Best-corrected distance acuity (in the better eye) of worse than
20/60 but better or equal to 20/200, or a reduced visual field
between 60 and 20 degrees
Severe Best-corrected distance acuity (in the better eye) of worse than
20/200 but better or equal to 20/400, or a reduced visual field
between 20 and 10 degrees
Profound Best-corrected distance acuity (in the better eye) of worse than
20/400, or a reduced visual field of less than 10 degrees
4 N. MARTINIELLO ET AL.

demographic and historical information pertaining to the usage Table 2. Sample demographics (N = 466; *See specific definitions for vision level
in Q7 of the survey instrument. **Note that only 70% of respondents provided
of traditional assistive devices. The remainder of the survey this information and that a single respondent could have reported multiple
inquired about the use of smartphones and tablets, including diagnoses to be counted in more than one category.).
the use of specific applications and accessibility features, and Variable N % of respondents
factors influencing the decision to select a particular main- Age
stream device. These questions also explored the degree to 18–39 years old 238 51.1%
40–59 year sold 171 36.7%
which mainstream devices are replacing traditional assistive 60+ 56 12.0%
solutions for the completion of a variety of daily tasks. (not reported) 1 0.2%
Age at Diagnosis
<1 year old 164 35.2%
1–5 years old 161 34.5%
Data analysis 6–17 years old 58 12.5%
18–34 years old 42 9.0%
The aim of this investigation, based on the a priori research 35–59 years old 20 4.3%
questions, is two-fold: to describe the specific devices, acces- 60+ years old 2 0.4%
(not reported) 19 4.1%
sibility features and apps that are used by participants with Sex
visual impairments, and to explore factors that potentially Male 216 46.4%
Female 247 53.0%
influence the decision to use mainstream rather than tradi- (not reported) 3 0.6%
tional devices for a variety of daily tasks. Kruskal–Wallis Country of Residence (N > 5)
H tests (and when appropriate, Dunn post-hoc tests with United States 246 52.8%
Canada 91 19.5%
the Benjamini-Hochberg multiple comparison adjustment Germany 64 13.7%
applied) were used to identify statistically significant differ- United Kingdom 17 3.7%
Australia 11 2.4^
ences in the categorical independent variables (McKnight & Czech Republic 6 1.3%
Najab, 2010). User proficiency levels with various devices India 6 1.3%
Level of Education
were collected based on a self-reported categorization of Some High School 23 4.9%
Beginner, Intermediate, and Advanced. For questions High School 82 17.6%
where participants were asked to rank device features Vocational Training 34 7.3%
College Degree 70 15.0%
based on importance, respondents’ top 3 choices were Undergraduate Degree 150 32.2%
assigned values of 3, 2, and 1, respectively, with all other Graduate/Postgraduate Degree 107 23.0%
Employment Status
options given a weight of 0 (such that higher weights in the Unemployed 92 19.7%
analysis represent more preferred choices). As the distribu- Student 59 12.6%
tion of these values was not consistent across different levels Employed, Part-Time 51 10.9%
Employed, Full-Time 162 34.8%
of the independent variables, the mean score (rather than Self-Employed 48 10.3%
median) for each feature was used as the data for analysis. In Retired 54 11.6%
Degree of Vision Loss*
all instances, analyses were conducted with an alpha .05 Mild 9 1.9%
significance level, and ε2 is reported to describe the magni- Moderate 30 6.4%
tude of effects. No multiple comparison adjustments were Severe 78 16.7%
Profound 349 74.9%
employed in the primary analyses because in this prelimin- Diagnoses** (N > 5)
ary exploratory research, we did not wish to prematurely Retinitis of prematurity 60 12.9%
Glaucoma 47 10.1%
discard potentially useful observations that may generate Leber congenital amaurosis 33 7.1%
hypotheses for follow-up studies (Streiner & Norman, Cataract(s) 21 4.5%
2011). All analyses were performed using R Statistical Retinal detachment 19 4.1%
Optic nerve hypoplasia 19 4.1%
Software (Foundation for Statistical Computing, Vienna, Nystagmus 12 2.6%
Austria), version 3.4.4. Retinal blastoma 10 2.2%
Albinism 10 2.2%
Where applicable, open-ended questions have also been Diabetic retinopathy 10 2.2%
included to gather qualitative data in order to provide addi- Optic nerve atrophy 8 1.7%
Macular degeneration 8 1.7%
tional context about influential factors that could not be Aniridia 6 1.1%
predicted in advance (O’Cathain & Thomas, 2004). As these Septo-optic dysplasia 6 1.1%
responses were small in number, they are not included in the Coloboma 6 1.1%
analysis of the current study.

Results The remaining 7.9% of responses were received from less

Demographics
Table 2 shows a detailed demographic profile of the sample
represented by the 466 completed responses received and
included in the analysis (age M = 41, SD = 14, range
18–80). Responses received emanated primarily from indivi-
duals in the United States (52.8%), Canada (19.5%), Germany
(13.7%), the United Kingdom (3.7%), and Australia (2.4%).
represented countries. Slightly more than half of the respon-
dents (51%) were between the ages of 18 and 39; 37% were
between the ages of 40 and 59; and 12% were 60 years and
older. 70.2% had at least a college degree and most (56%) were
employed on at least a part-time basis. 75% of respondents
self-reported profound vision loss, while 17% had severe
losses, 6% had moderate losses, and 2% had mild losses.
A majority (69.7%) of respondents had been diagnosed with

Figure 1. Self-reported proficiency in the use of traditional assistive devices among users of each device. Note. CCTV = closed-circuit television; PC = personal
computer.
vision loss as infants or toddlers; 12.5% between the ages of 6
and 17; 9% between the ages of 18 and 34; 4.3% between the
ages of 35 and 59; and 0.4% over the age of 60 (4.1% not
reported).
Participants were asked to indicate which traditional assis-
tive devices they use, and were permitted to select more than
one device. All but one respondent had experience using one
or more traditional assistive devices to complete a wide vari-
ety of daily tasks, including PCs with screen readers (85%),
audio book readers (59%), braille displays (54%), PCs with
magnification software (28%), handheld or digital magnifiers
(22%), or CCTVs (19%). The self-reported degree of vision
loss impacted the likelihood that a participant would use PCs
with screen readers (H(1) = 104.89, ε2 = .17, p < .001), braille
displays (H(1) = 61.43, ε2 = 0.11, p < .001), PCs with magni-
fication software (H(1) = 111.79, ε2 = 0.18, p < .001), magni-
fiers (H(1) = 125.02, ε2 = 0.22, p < .001), and CCTVs (H(1) =
52.83, ε2 = 0.10, p < .001). As shown in Figure 1, most
participants considered themselves to have ‘intermediate’ or
‘advanced’ skills with these technologies. While their age did
not impact on proficiency, those with more severe vision
losses reported higher levels of proficiency for the use of
braille displays (H(3) = 64.04, ε2 = 0.14, p < .001) and PC
with screen readers (H(3) = 85.86, ε2 = .18, < .001). Age of
diagnosis impacted on self-reported proficiency with respect
to magnifiers (H(5) = 30.10, ε2 = .07, p < .001), braille displays
(H(5) = 71.23, ε2 = .16, p < .001) and PCs with screen readers
(H(5) = 42.51, ε2 = .10, p < .001), with those diagnosed at
older ages feeling less proficient than those diagnosed at
younger ages.
Participants were asked to select the sources of training
and technical support they accessed for their traditional assis-
tive devices, and for both questions, respondents could select
more than one option. Respondents reported learning to use
their traditional assistive devices through self-learning (58%),
ASSISTIVE TECHNOLOGY 5
web-based resources (52%), vision rehabilitation professionals
(42%), other users with visual impairments (42%), and from
sighted friends and family (18%). Technical support and trou-
bleshooting assistance was sourced from web-based resources
(76%), other users with visual impairment (57%), sighted
friends and family (26%), and vision rehabilitation profes-
sionals (18%). Among respondents, 3% (including 10% of
those who lost their vision between age 35 and 59 and a full
half of those who lost their vision after age 60) indicated that
they did not know where to attain technical support for their
traditional assistive devices.
What mainstream devices, apps, and features are being
used?
Most participants (97%) used a smartphone, 49.5% used both
a smartphone and a tablet, and only 3% of respondents used
a tablet alone. Those with moderate and severe vision losses
were slightly less likely to use a smartphone (93% and 92%,
respectively) than those with mild or profound losses (100%,
99%, H(3) = 11.18, ε2 = .02, p = .011). Likewise, those with
severe and profound vision losses were less likely to use a tablet
(65% and 46%, respectively) than those with mild or moderate
losses (78% and 83%, H(3) = 24.55, ε2 = .05, p < .001).
Smartphones
A majority of smartphone users (89.8%) had more than 3
years of experience using their smartphone, with 7.5% having
1–2 years experience and 2.7% having less than one year of
experience. The most commonly used operating system for
smartphones was Apple iOS (82%), with 17% running
Android, and less than 1% running Windows. When asked
to select all the factors which influenced the decision to
purchase a specific smartphone brand, the most common
reasons for having selected the particular smartphone brand
6 N. MARTINIELLO ET AL.
included its accessibility features (63%), it having been recom-
mended by other blind or visually impaired acquaintances
(11%), it being easy to use (7%), or it having been received
as a gift (3%). When selecting a phone for purchase, partici-
pants indicated that the most important features (on a 3-point
scale) were accessibility (M = 2.55, SD = 0.86), effectiveness
(M = 1.26, SD = 1.04), durability (M = 0.54, SD = 0.83),
dimensions (M = 0.53, SD = 0.91), weight (M = 0.44, SD =
0.77), security (M = 0.38, SD = 0.75), and comfort (M = 0.30,
SD = 0.65). Those with mild (M = 1.57, SD = 1.27) to
moderate (M = 1.65, SD = 1.31) vision losses were signifi-
cantly less concerned about accessibility than those with
severe (M = 2.46, SD = 0.97) and profound (M = 2.66, SD =
0.71) losses: H(3) = 27.58, ε2 = .08, p < .001. Similarly, those
with mild (M = 1.57, SD = 1.40) to moderate (M = 1.20, SD =
1.24) vision losses were significantly more concerned about
the dimensions of the device than those with severe (M = 0.88,
SD = 1.08) and profound losses (M = 0.38, SD = 0.76): H(3) =
29.61, ε2 = .08, p < .001. The demographic factors considered
(age, age of diagnosis, degree of vision loss, and proficiency)
did not result in any statistically significant differences with
respect to the other features (effectiveness, durability, weight,
security, or comfort).
Most users relied on self-learning (69%), web-based
resources (58%), or the assistance of other visually impaired
users (43%) to learn how to use their smartphones, with only
18% receiving training and assistance from sighted friends
and family and a mere 7.5% receiving assistance from vision
rehabilitation professionals. For technical support purposes,
the most common sources of assistance included web-based
resources (76%), other visually impaired users (50%), sighted
friends and family (30%), and vision rehabilitation profes-
sionals (8.2%). Only 2.4% of respondents indicated that they
were not aware of where technical support could be attained.
Participants generally believed themselves to be skilled
smartphone users, with 71% reporting advanced proficiency,
26% reporting intermediate proficiency, and 3% reporting
beginner proficiency. Age (H(2) = 24.85, ε2 = .06, p < .001)
and age at diagnosis (H(5) = 13.62, ε2 = .03, p = .018)
impacted on smartphone proficiency, with older individuals
generally feeling less proficient than younger individuals
(Cramer’s V = .17). Moreover, degree of vision loss (H(3) =
21.61, ε2 = .05, p < .001) influenced proficiency, with those
having more severe vision loss feeling more proficient than
those with mild or moderate losses.
Tablets
With respect to tablets, most tablet users (70%) had more
than 3 years of experience with their tablet device, with 19%
having 1–2 years experience and 11% having less than
one year of experience. In total, 79% of tablets were Apple
iOS-based, while 18% ran on Android, and 3% ran on
Windows. The most common reasons for having selected
this particular tablet brand included its accessibility fea-
tures (50%), it having been received as a gift (11%), it
being easy to use (11%), it being affordable (5%), and
recommendations from other blind and visually impaired
users (4.9%). When selecting a tablet to purchase, partici-
pants indicated that the most important features (on
a 3-point scale) were accessibility (M = 2.31, SD = 1.06),
effectiveness (M = 1.22, SD = 1.11), weight (M = 0.65, SD =
0.90), dimensions (M = 0.65, SD = 1.01), durability
(M = 0.57, SD = 0.79), comfort (M = 0.36, SD = 0.76),
and security (M = 0.24, SD = 0.68). As with phones, those
with mild (M = 1.83, SD = 1.17) to moderate (M = 1.35, SD
= 1.27) vision losses were significantly less concerned about
accessibility than those with severe (M = 2.27, SD = 1.10)
and profound (M = 2.48, SD = 0.94) losses: H(3) = 17.02, ε2
= .09, p = .001. Similarly, those with mild (M = 1.33, SD =
1.21), moderate (M = 1.35, SD = 1.22), and severe (M =
1.24, SD = 1.12) vision losses were significantly more con-
cerned about the dimensions of the device than those with
profound losses (M = 0.34, SD = 0.77): H(3) = 38.93, ε2 =
.21, p < .001. The demographic factors considered (age, age
of diagnosis, degree of vision loss, and proficiency) did not
result in any statistically significant differences in respect of
the other features (effectiveness, durability, weight, secur-
ity, or comfort).
Most users relied on self-learning (75%), web-based
resources (46%), or the assistance of other visually impaired
users (21%) to learn how to use their tablets, with only 15%
receiving training and assistance from sighted friends and
family and just 7% receiving assistance from vision rehabilita-
tion professionals. For technical support purposes, the most
common sources of assistance included web-based resources
(73%), other visually impaired users (38%), sighted friends
and family (24%), and vision rehabilitation professionals
(9.8%). Only 1.6% of respondents indicated they were not
aware of where technical support could be attained.
Age (H(2) = 22.79, ε2 = .09, p < .001) but not age at diagnosis
impacted proficiency, with those over 60 being significantly less
likely to report ‘advanced’ proficiency than those in any other
age group. The degree of vision loss also influenced proficiency
(H(3) = 9.97, ε2 = .04, p = .019), with those having mild or
moderate losses being less likely to report advanced proficiency
than those with severe or profound losses.
Smartphone and tablet features and applications used
Of the 466 respondents, 95% reported that they used their
device to make phone calls; 93% to send and receive text
messages; 92% to browse the web, 92% to read e-mail; 83%
to listen to music; 81% for social media; 75% for calendar
functions; 67% to take photos; 61% for reminders; and 53% to
participate in video calls.
A detailed investigation was undertaken to explore the use
that participants were making of their smartphones and
tablets to perform a wide range of daily living tasks that
might previously have been aided by traditional assistive
devices. The number of respondents using their devices for
these tasks, and the factors which were found to influence the
likelihood of use, are summarized in Table 3.
Are mainstream devices replacing traditional assistive
devices?
Participants were asked to which extent they agreed with the
statement, “Overall, I feel that my smartphone or tablet compu-
ter has replaced the use of my other assistive devices” on the
 ASSISTIVE TECHNOLOGY 7

Table 3. Proportion of respondents reporting the use of smartphone and tablets feature for accomplishing specific tasks and associated demographic factors (shaded
values are significant, p < .05).
Associated factors
% of smartphone
Task N and tablet usage Age Age of diagnosis Vision level Proficiency
Audiobooks 333 71%
H(2) = 0.04, H(5) = 5.12, p = .401 H(3) = 9.25, ε2 = .02, H(2) = 14.18, ε2 = .03,
p = .98 p = .026 p = .001
Braille Input 125 27%
H(2) = 13.81, H(5) = 15.76, ε2 = .05, H(3) = 23.60, ε2 = .05, H(2) = 22.06, ε2 = .05,
ε2 = .03, p = .008 p < .001 p < .001
p = .001
Color Identification 149 32%
H(2) = 2.76, H(5) = 5.75, p = .331 H(3) = 32.54, ε2 = .07, H(2) = 5.68, p = .058
p = .252 p < .001
Reading e-Books 306 66%
H(2) = 4.86, = H(5) = 16.26, ε2 = .04, H(3) = 7.36, p = .061 H(2) = 36.43, ε2 = .08,
.088 p = .006 p < .001
Light Detection 142 30%
H(2) = 3.59, H(5) = 6.58, p = .254 H(3) = 28.18, ε2 = .06, H(2) = 13.19, ε2 = .03,
p = .166 p < .001 p = .001
Magnification 84 18%
H(2) = 4.65, H(5) = 4.96, p = .421 H(3) = 83.50, ε2 = .18, H(2) = 1.48, p = .477
p = .098 p < .001
Recording Memos 231 50%
H(2) = 10.32, H(5) = 1.75, p = .883 H(3) = 4.08, p = .253 H(2) = 14.24, ε2 = .03,
ε2 = .02, p = .001
p = .006
Navigation 371 80%
H(2) = 3.56, H(5) = 5.81, p = .325 H(3) = 13.31, ε2 = .03, H(2) = 34.50, ε2 = .08,
p = .168 p = .004 p < .001
Object Identification 286 61% H(2) = 22.70, ε2 = .05,
H(2) = 5.15, H(5) = 17.27, ε2 = .05, H(3) = 64.78, ε2 = .14, p < .001
p = .076 p = .004 p < .001
OCR 324 70%
H(2) = 6.16, ε2 H(5) = 16.57, ε2 = .04, H(3) = 73.47, ε2 = .16, H(2) = 32.15, ε2 = .07,
= .01, p = .046 p = .005 p < .001 p < .001
Sighted Help 182 39%
H(2) = 5.80, H(5) = 11.64, ε2 = .04, H(3) = 35.34, ε2 = .08, H(2) = 17.62, ε2 = .04,
p = .055 p = .04 p < .001 p < .001
Note. OCR = optical character recognition.

basis of a 5-point Likert scale (Totally disagree, Disagree,
Somewhat agree, Agree, Totally agree). It was found that 62.5%
agreed or totally agreed; 24.8% somewhat agreed; and 12.7%
disagreed or totally disagreed. Younger participants (H(2) =
8.22, ε2 = .02, p = .016) and those with greater proficiency (H
(2) = 36.6, ε2 = .08, p < .001) felt more strongly that this
replacement was occurring.
To explore this question at a more granular level, the responses
to four interrelated questions in the survey instrument (Q42
through Q45) were consolidated and analyzed: Among indivi-
duals who required the use of an assistive device to perform
a specific task, and who had used or continued to use traditional
assistive devices to accomplish those tasks, to what degree were
they now using their smartphone or tablet devices in place of
traditional devices for these tasks? The results of that analysis are
presented in Figure 2 and corroborate the self-reported perception
that smartphones and tablets are taking the place of traditional
assistive devices at least some of the time for all of the identified
tasks.
What factors influence device usage?
A variety of demographic factors including age, age at diag-
nosis, degree of vision loss, and proficiency with their device
were found to influence the degree to which this replacement
was occurring depending on the task at hand. Table 4 iden-
tifies the factors which were found to contribute to statistically
significant differences in the degree to which mainstream
devices were replacing traditional assistive devices for
a variety of tasks.
At the most general level, participants were asked to which
extent they agreed with the statement, “It is important to me
that I use a smartphone or tablet computer like everyone else,
rather than a specialized assistive device.” Overall, 69.6%
agreed or totally agreed with this statement; 17.8% somewhat
agreed; and 12.6% disagreed or totally disagreed. User profi-
ciency levels impacted these perceptions, with more proficient
users agreeing more strongly with the statement (H(2) =
17.06, ε2 = .04, p < .001).
When asked about the extent to which respondents
agreed that having physical buttons on a device is important,
more than half of respondents (56.9%) disagreed or totally
disagreed with this statement, 25.9% somewhat agreed, and
17.2% agreed or totally agreed. User proficiency impacted
these perceptions, with less proficient users agreeing more
strongly with the statement (H(2) = 28.79, ε2 = .06, p < .001).
Open-ended comments here clarify that the incorporation of
physical buttons depends upon the task, with participants
highlighting the value of physical buttons for text input and
more extensive writing tasks.
8 N. MARTINIELLO ET AL.

Figure 2. Frequency of mainstream device usage in place of traditional devices for specific tasks.
Note. OCR = optical character recognition.

Table 4. Factors that influence the degree of replacement of traditional devices by smartphones or tablets for specified tasks (shaded values are significant, p < .05).
Influencing factors
Task N Age Age of diagnosis Vision level Proficiency
Audiobooks 372
H(2) = 7.72, ε2 = .02, H(5) = 5.20, p = .392 H(3) = 0.27, p = .966 H(2) = 14.92, ε2 = .04,
p = .021 p = .001
Braille Input 150
H(2) = 10.16, ε2 = .07, H(5) = 4.51, p = .341 H(3) = .81, p = .666 H(2) = 17.94, ε2 = .12,
p = .006 p < .001
Color Identification 188 H(3) = 4.95, p = .084
H(2) = 1.05, p = .592 H(5) = 3.08, p = .545 H(2) = 1.06, p = . 588
Reading e-Books 337
H(2) = .64, p = .726 H(5) = 7.35, p = .118 H(3) = 2.98, p = .395 H(2) = 13.08, ε2 = .04,
p = .001
Light Detection 137
H(2) = .45, p = .797 H(5) = .63, p = .96 H(3) = 4.16, p = .125 H(2) = 3.55, p = .169
Magnification 109
H(2) = 3.62, p = .164 H(5) = 1.48, p = .915 H(3) = 3.73, p = . 292 H(2) = 1.56, p = . 459
Recording Memos 279
H(2) = 9.92, ε2 = .04, H(5) = 7.67, p = .175 H(3) = .55, p = .907 H(2) = 11.50, ε2 = .04,
p = .007 p = .003
Navigation 338
H(2) = 17.50, ε2 = .05, H(5) = 14.16, ε2 = .04, H(3) = 12.29, ε2 = .04, H(2) = 6.68, ε2 = .02,
p < .001 p = .015 p = .006 p = .035
Object Identification 243
H(2) = 21.86, ε2 = .09, H(5) = 11.18, ε2 = .05, H(3) = 4.59, p = .204 H(2) = 9.85, ε2 = .04,
p < .001 p = .025 p = .007
OCR 332
H(2) = 3.28, p = .194 H(5) = 2.31, p = .68 H(3) = 1.44, p = . 696 H(2) = 12.00, ε2 = .04,
p = .002
Sighted Help 162
H(2) = 1.20, p = .55 H(5) = 5.61, p = .23 H(3) = 1.09, p = .578 H(2) = 5.68, p = .058
Note. OCR = optical character recognition.

Discussion
It is evident that mainstream smartphone and tablet devices fulfill
an important role in the lives of individuals who are blind or who
have low vision. While the above findings demonstrate the impact
of such devices, they also provide imperative context about the
different ways in which such mainstream tools are used by diverse
segments of the visually impaired population and accentuate that
users with visual impairments constitute a heterogenous

population. Demographic variables including age, age at diagno-
sis, degree of vision loss, and proficiency impact the degree to
which individuals choose to use their smartphones or tablets to
complete tasks, and the extent to which they have replaced tradi-
tional assistive devices. Ultimately, such distinctions are vital to
consider both within design and training interventions and high-
light the diverse needs that exist among users with visual
impairments.
Mainstream devices and features being used
A vast majority of participants (97%) choose to use
a smartphone rather than a tablet, excluding those with mild
or moderate visual impairments who are slightly more likely to
select a tablet for specific tasks. This coincides with the fact that
participants with milder visual impairments placed greater
emphasis onscreen dimension as an important feature taken
into consideration when selecting a device. Setting aside the
degree of vision, however, it is important to highlight that the
preference for smartphones above tablets spans across all age
groups in this study. Strikingly, participants on average describe
using as many as 11 separate traditional devices to complete
tasks (M = 5.32, SD = 2.58), whereas it can be seen that these
same tasks in a majority of cases are now completed through the
use of a mainstream device alone.
Here, portability is accentuated by one participant as an impor-
tant advantage of the smartphone, as it minimizes the need to
carry multiple devices simultaneously: “I replaced a lot of small
devices with one small device. I love that. Mobility is the real
advantage”. This is further evidenced by the fact that a full 80% of
participants use a smartphone for navigation purposes (outdoor
GPS) rather than as tools that are exclusively employed within the
home. Similarly, the escalating accessibility of mainstream appli-
cations such as Audible, iBooks and Kindle – as well as applica-
tions which provide optical character recognition – increase
access to electronic information, where it was often not available
beforehand. In this way, mainstream devices that incorporate
universal design can be understood as not merely providing
a means to perform tasks, but also as tools which invigorate the
universal availability of accessible texts through guidelines that
encourage application designers to meet accessibility standards.
Overall, the top five tasks listed in Figure 2 highlight that
mainstream devices, in many cases, are functioning as multi-
purpose tools that facilitate independence in increasingly diverse
contexts. These findings emphasize the need for future trainers
and rehabilitation personnel to view the training in the use of
mainstream devices not as a specialized, insular activity, but one
that should be increasingly understood through an interdisci-
plinary lens (Bronstein, 2003). Rehabilitation training and care
has traditionally been fragmented, with technology training
offered separately from other disciplines such as activities of
daily living and orientation and mobility instruction (Hinds
et al., 2003). However, it is clear that such mainstream solutions
are markedly different from many traditional devices that are
designed to perform a more restricted scope of tasks, and, as
expressed by one participant, clients should, therefore, be pro-
vided with opportunities to understand the full potential of such
mainstream tools within the context of their overall rehabilita-
tion goals:
ASSISTIVE TECHNOLOGY 9
The real challenge is to make certain blind people who get these
devices are made aware of the possibilities and how to work the
accessibility features. I’ve run into a number of people with these
devices who had no idea about the access technology [these
devices] contained or how to use it (…) These are life-changing
devices if people are able to connect the dots.
Despite these identified advantages, participants also accent-
uate that mainstream smartphones and tablets are limiting in
some instances and cannot replace the use of traditional tools
for the completion of certain tasks, particularly as these per-
tain to extensive typing and editing needs. As characterized by
one participant, “an iPhone can replace most standalone
assistive technologies, but it cannot replace a desktop compu-
ter”. Slightly more than half of participants (56%) disagreed to
at least some extent with the statement that physical buttons
were an essential feature of a device, with participants describ-
ing the effective use of dictation and on-screen braille input
for briefer text entry functions. Though participants described
feeling reluctant to use a device that did not incorporate
physical buttons prior to learning the use of their smartphone
or tablet, a common theme was that this intimidation
decreased quickly once they gained proficiency. Indeed,
those with greater proficiency were significantly less likely to
prefer devices with traditional physical buttons. However,
even among more proficient mainstream device users, com-
ments also highlight that it is imperative to understand the
limits of such tools which cannot replace more sophisticated
traditional devices used for document management purposes.
This preference for physical buttons for extensive typing
needs is also echoed in findings by Watanabe et al. (2015),
and Caprani, O’Connor, and Gurrin (2012) further explore
the potential benefit of traditional physical buttons for older
adults with cognitive and motor impairments when complet-
ing certain tasks. Our findings, therefore, raise the value of
viewing traditional and mainstream devices not as opposing
options, but as existing on a continuum of solutions which
may be employed depending on the task to be performed.
Consideration of specific user needs and the tasks to be
performed are vital to contemplate both at the design stage
and within assessment and training contexts. In this way, the
best device must not merely depend upon the user, but on the
specific task in question for that user.
Replacement of traditional devices
Our findings provide overwhelming evidence that in this
sample, mainstream devices are now replacing traditional
assistive solutions. This is especially true for object identifica-
tion, navigation, requesting sighted help, listening to audio-
books, reading eBooks and optical character recognition,
where in each case, at least two-thirds of respondents indi-
cated that mainstream devices were replacing traditional tools
most or all of the time (see Figure 2). These results are
consistent with the fact that a full 87.4% of participants agreed
at least to some extent with the statement that, overall, main-
stream devices are replacing the use of traditional assistive
solutions. Similarly, a vast majority of respondents (87.4%)
agreed at least to some extent that it is important for them to
use a mainstream device that is adopted by the general public,
10 N. MARTINIELLO ET AL.
alluding to the avoidance of tools which may work to separate
users from the norm. Interestingly, prior research has found
that an iPad and a portable CCTV are essentially equivalent
from a functional perspective (Morrice, Johnson, Marinier, &
Wittich, 2017; Wittich, Jarry, Morrice, & Johnson, 2018),
suggesting that the decision to replace a traditional assistive
device with a mainstream solution may be driven by reasons
above and beyond functional factors.
The influence of stigma and social acceptance, especially
among those with invisible or newly acquired impairments, is
well established in previous research (Mulloy et al., 2014), and
findings from this study suggest that this is true among users
with visual impairments as well. Fraser, Kenyon, Lagacé,
Wittich, and Southall (2015) conducted a critical discourse
analysis of text published between January 2009 and 2013 in
a major Canadian newspaper, examining stereotypical depic-
tions of age-related conditions and assistive device usage. It
was found that depictions of aging and assistive device usage
often exacerbate existing stereotypes, and may consequently
lead to a reduction in help-seeking and lower overall assistive
device adoption (Fraser et al., 2015). The overwhelming
agreement among participants in this study who affirm their
preference to use widely accepted devices is especially relevant
as the prevalence of acquired age-related vision loss continues
to increase, with this number expected to double by 2050
(Varma et al., 2016).
Stigma, however, is not the only factor contributing to the
preference to use a mainstream rather than a traditional
device. Open-ended comments highlighted the fact that such
mainstream devices are more affordable, more intuitive to
use, and require less bureaucratic paperwork to obtain:
It’s not so much important to me that I can use the same device
like everyone else for blindness pride reasons. However, from
a financial and affordability standpoint, I am thankful I can use
the same kind of device as everyone else, instead of having to
either spend money I don’t have for specialized devices or soft-
ware, or having to justify to get rehab to pay for it.
Influential factors: Relationship between proficiency and
usage
For many tasks, age and proficiency impact the degree of
replacement (with younger and more proficient users being
more likely to replace their traditional assistive devices).
While correlations were observed between proficiency and
age and age at diagnosis, proficiency (rather than age) was
more commonly identified as a significant factor. In other
words, also among those older adults who self-report higher
proficiency, mainstream devices are replacing the use of tradi-
tional assistive solutions for a majority of tasks most or all of
the time. These results suggest that proficiency, rather than
age, is the driving influential factor which determines device
usage and degree of replacement. As participants across all
ages become more proficient and comfortable with the use of
their mainstream devices, they are more likely to prefer
a smartphone or tablet for the completion of a majority of
tasks.
These findings raise the need to invest training and pro-
gram resources to facilitate the learning of such mainstream
devices, particularly when considering the expressed prefer-
ence of most participants to use a device that is widely
accepted by others. While 42% of participants still rely on
vision rehabilitation professionals for the training of tradi-
tional devices, only 7% turn to such specialists for the training
and technical support of their smartphones and tablets.
Instead, a majority depend upon online resources and other
visually impaired acquaintances, likely influenced by the
greater availability of online training and technical support
for mainstream products that are sold to the general public.
As expressed by one participant,
If the phone needs to be repaired, I can go to the store within
a couple of days. If a specialized device needs to be repaired,
there’s more jumping through hoops involved and it takes forever
for the device to get back to me.
This being said, participants in this study who acquired their
vision loss after age 60 were still more likely to rely upon
rehabilitation professionals for such support, and are more
likely to be unaware of where to seek technical support when
problems arise. Though not specifically focused on age-related
vision loss, the difficulty of securing technical assistance was
highlighted in prior work by Jarry et al. (2017). Given that
proficiency appears to be related to usage, future design and
training programs must consider ways to harness online and
external resources for more proficient users who can rely on
such supplements, while bolstering traditional training and
supports for older and less proficient users who appear to be
experiencing gaps, as this may influence their ability to
employ mainstream devices for more complex tasks.
Shifting priorities and definitions
Given the widespread replacement of traditional assistive
devices for many tasks, these findings also provide strong
support for programs and initiatives which increase the avail-
ability of such mainstream tools for users with visual impair-
ments who may otherwise face financial restrictions. The
CNIB Phone It Forward program (CNIB, 2018), for instance,
collects and refurbishes old and unused smartphones from the
general public and redistributes them to blind and low-vision
users who otherwise would not have access to these tools.
Though mainstream smartphones and tablets are undoubtedly
less costly than many traditional assistive devices, most exist-
ing funding programs, such as the government health insur-
ance in Quebec, Canada, do not include these mainstream
devices among those aids which are eligible for funding (Régie
de l’assurance maladie du Québec [RAMQ], 2018). This may
still pose a barrier to those who experience financial difficul-
ties, which is especially relevant given the prevalence of both
people with disabilities and older adults who live close to or
below the poverty line in most western countries (Martiniello
& Wittich, 2019). As participants in this study are typically
using a single mainstream device in place of several traditional
solutions, funding such mainstream devices would alleviate
the financial burden placed on existing governmental pro-
grams. This will become increasingly pertinent to consider
as the prevalence of age-related vision loss continues to place
additional burdens on existing governmental programs

(Varma et al., 2016). Though a caveat should also be made
that the continued funding of traditional devices must be
maintained for those users and tasks where it is deemed
more appropriate, existing paradigms should also accommo-
date these shifting trends and harness the full potential that
mainstream solutions afford.
A final central theme warrants reflection. Participants in
this study not only described how and when smartphones and
tablets replaced traditional assistive devices, but also provided
a nuanced understanding of what constitutes an ‘assistive
device’ in the first place. Interestingly, mainstream features
not inherently designed to solve accessibility challenges can
and are being used by participants:
An advantage of having a smartphone is that if you are lost you
can send your location to a sighted friend or family member so
that they can either come and get you or direct you from the map.
Though functionalities such as video-calling were not
designed to address difficulties (such as requesting sighted
assistance when lost), these mainstream features are seemingly
taking on the role of ‘assistive device’ in such cases. In this
way, smartphones and tablets are ultimately enabling partici-
pants to not only perform a wider range of tasks, but are also
shifting the definition of ‘assistive device’ to include main-
stream products that are being harnessed in increasingly crea-
tive and flexible ways.
Limitations and future research
The majority of participants in this convenience sample were
younger, more advanced technology users, likely due to the
social media recruitment efforts and the fact that data collec-
tion occurred through an online survey. While a subset of
participants (n = 56) in this study were over the age of 60, the
majority were working-age adults with profound congenital
visual impairments. Our results provide a starting point for
understanding the experiences of older adults or those with
acquired visual impairment who may not have extensive prior
experience with assistive devices. Future research should,
therefore, strive to gain a more in-depth understanding of
this growing population and their unique needs.
Moreover, while the survey instrument did endeavor to
gather information from those with additional impairments
such as those with dual sensory loss, this was not the primary
aim of the investigation and thus these data are limited in
scope. Future research should likewise focus more explicitly
on the implications of comorbidity on device usage, particu-
larly as many users may acquire multiple impairments as
a consequence of normal aging, and the very nature of
a disability may also depend on the environment and context
(Wittich, Southall, & Johnson, 2016). Such users may have
different or compounding needs compared to those with
visual impairment alone. Given the suite of accessibility fea-
tures increasingly available on mainstream smartphones and
tablets, future research should explore how effectively such
tools meet different and sometimes opposing needs for the
same user.
While our study focused on those who already have access
to a smartphone or tablet (regardless of how frequently they
ASSISTIVE TECHNOLOGY 11
choose to use these mainstream options), future investigations
should also explore those who choose not to acquire
a smartphone or tablet at all in favor of using traditional
devices, particularly among older adults who may be long-
term users of traditional assistive devices. Likewise, the cur-
rent study did not directly inquire about the impact of costs
associated with a device after procurement which may be an
important question to explore in future research.
Finally, the current study, in common with many online
surveys, is based on broadly defined self-reported degrees of
visual impairment, making it difficult to extrapolate the actual
functional experience of participants. Future investigations
which incorporate both objective and self-reported measures
would provide useful context and a more wholistic image of
sensory functioning.
Conclusion
As the ubiquity of mainstream devices continues to increase, it
is essential to explore not only the impact of such devices within
the visually impaired population as a whole, but also the ways in
which this may differ among diverse segments of user popula-
tions. Within our sample, mainstream devices are replacing the
use of traditional devices most or all of the time, but specific
tasks still require the use of traditional methods. Moreover, as
users become more proficient, they are more likely to choose
mainstream devices that are widely adopted by the general
population. Ultimately, future designers, trainers, and govern-
mental programs must adapt to accommodate these shifting
trends, in order to ensure that such mainstream tools are
harnessed to their fullest potential where appropriate.
Acknowledgments
We would like to acknowledge the Fonds de recherche santé du Québec
(FRQS Grant No. 32305), the CNIB Ross C. Purse Doctoral Fellowship,
and the Bavarian Quebec Research Alliance for funding this research. We
would also like to thank Magdalena Bittner for her contributions in the
development of the survey instrument.
Funding
This work was supported by the Fondes de Recherche Quebec Santé
(FRQS) [# 32305]; CNIB Ross C. Purse Doctoral Fellowship [not applic-
able]; Bavarian-Québec Research Alliance.
Declaration of Interest
None of the authors report any potential conflict of interest in respect of
this research.
ORCID
Natalina Martiniello http://orcid.org/0000-0002-2739-8608
Christine Lehane http://orcid.org/0000-0001-7872-0890
Walter Wittich http://orcid.org/0000-0003-2184-6139
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